Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301082141 | MI |
N | 111NI0900X | Internist | 4301082141 | MI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 4301082141 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301082141 | MI |
NPI | 1861605362 |
---|---|
Provider Name | Cristina Tita |
First Address | Detroit, MI 48202-2608 |
Second Address | Jackson, MI 49201-1800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 22/06/2020 |